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Self-compounded Doxycycline Sclerotherapy for the Treatment of Lymphatic Malformations in Low-Resource Settings

  • Surgery in Low and Middle Income Countries
  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

Congenital anomalies are one component of the overwhelming surgical disease burden in low- and middle-income countries (LMICs). Lymphatic malformations (LMs) are a common congenital deformity of the head and neck in which the utilization of sclerotherapy may avoid surgery and yield superior outcomes. To be useful in LMICs, sclerosing agents must be widely available, inexpensive, and effective.

Methods

A retrospective review of 10 pediatric patients with macrocystic or mixed LMs who were treated with self-compounded doxycycline sclerotherapy at Rwanda’s Central University Teaching Hospital of Kigali was performed. Doxycycline oral tablets were crushed by hand, mixed with normal saline at a concentration of doxycycline 10 mg/mL, and injected directly into LMs of the head and neck.

Results

Ten pediatric patients underwent 21 sclerotherapy sessions with a mean of 2.1 sessions per patient (SD 1.3, range 1–5). Of the 8 patients that were seen in follow-up, all achieved at least 80% resolution, 6 of 8 achieved 100% resolution, and none required surgery. One patient developed an infection at the injection site which resolved with antibiotics.

Conclusions

Self-compounded doxycycline sclerotherapy is a safe, effective, and widely available treatment option for sclerotherapy of LMs in LMICs.

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Acknowledgements

This study was granted Institutional Review Board approval by the Central University Teaching Hospital of Kigali.

Funding

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Authors and Affiliations

  1. Facial Plastics and Reconstructive Surgery, Department of Otolaryngology, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, 02114, USA

    David A. Shaye, Ciersten A. Burks & Shekhar K. Gadkaree

  2. Department of Otolaryngology, Central University Teaching Hospital, Kigali, Rwanda

    David A. Shaye, Isaie Ncogoza, Gratien Tuyishimire, Victor Nyabyenda & Aaron Gassore

Authors
  1. David A. Shaye
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  2. Ciersten A. Burks
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  3. Shekhar K. Gadkaree
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  4. Isaie Ncogoza
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  5. Gratien Tuyishimire
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  6. Victor Nyabyenda
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Correspondence to David A. Shaye.

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Shaye, D.A., Burks, C.A., Gadkaree, S.K. et al. Self-compounded Doxycycline Sclerotherapy for the Treatment of Lymphatic Malformations in Low-Resource Settings. World J Surg 44, 3616–3619 (2020). https://doi.org/10.1007/s00268-020-05667-z

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  • DOI: https://doi.org/10.1007/s00268-020-05667-z

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